Provider Demographics
NPI:1235486598
Name:CONWAY, SHERI (APRN)
Entity Type:Individual
Prefix:
First Name:SHERI
Middle Name:
Last Name:CONWAY
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5631 FOX CHASE DR
Mailing Address - Street 2:
Mailing Address - City:HOKAH
Mailing Address - State:MN
Mailing Address - Zip Code:55941-8744
Mailing Address - Country:US
Mailing Address - Phone:608-519-3080
Mailing Address - Fax:
Practice Address - Street 1:4647 MORMON COULEE RD
Practice Address - Street 2:
Practice Address - City:LA CROSSE
Practice Address - State:WI
Practice Address - Zip Code:54601-8225
Practice Address - Country:US
Practice Address - Phone:608-519-3080
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-06
Last Update Date:2012-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI71707-30163W00000X
MNR117042-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse